经鼻腔内窥镜蝶窦鞍区手术解剖及其临床应用  

Anatomy study and clinical application of transnasal endoscopic surgery on sellar area of sphenoid sinus

作　　者：孙敬武[1] 汪银凤[1] 陈晓虹[1] 金自仓[1] 王明善[1] 叶非常[1] 刘认华[1] 

机构地区：[1]安徽省立医院耳鼻咽喉科,合肥市230001

出　　处：《中国临床解剖学杂志》2000年第3期199-200,共2页Chinese Journal of Clinical Anatomy

摘　　要：目的：为经鼻内窥镜蝶窦鞍区手术提供解剖学参数和临床经验。方法：在２０个尸头标本上观测蝶窦及周围重要解剖结构。结果：７７．５％的蝶窦口内窥镜直接窥见，窦口距离蝶窦顶壁、外壁、蝶腭动脉孔、鞍前壁、鼻中隔后端分别为 ８． ６±３． １ｍｍ、９． ２±１． ８ ｍｍ、 １１． １±１． ６ ｍｍ、 １４． ７±３． ６ ｍｍ、３． ６±０． ５ｍｍ，距离鼻小柱根部前缘 ６１．６ ± ３．７ ｍｍ，与鼻底夹角 ３１．８° ± ５． ２°。视神经管和颈内动脉在蝶窦外侧上隆起率分别为２５％和７２．５％。６９％蝶窦中隔非正中位。海绵窦前、下、后间窦出现率分别是８０％、５５％、３５％。结论：进行内窥镜蝶窦鞍区手术时注意蝶窦口、蝶窦外侧壁和蝶鞍底壁与周围结构关系，避免损伤重要血管神经。To provide anatomical parameter and clinical experience for transnasal endoscopic surgery on sellar area of sphenoid sinus. Methods: Sphenoid sinus and some structures around it were observed and measured on 20 adult cadavers. Results:77. 5% of sphenoid ostia can be identified by endoscope directly. The distances ho sphenoid ostia to the superior and lateral wall of sphenoid sinus, the foramen of sphenopalatine artery, the anterior wall of sella, posterior nasal septum and nasal column were 9.6±4. 1 mm.9.2 ± 1.8 mm,11. 1 ±1.6 mm,14.7 ± 3.6 mm,3.6± 0.5 mm and 61.6± 3.7 mm respectively.The angle between sphenoid ostia and nasal base is 31.8° ± 5.2°. 25% of optical nerve canal and 72.5% of internal carotid bugle on the area of lateral sphenoid sinus.69% of the septum Of sphenoid sinus is not cental.The rates of anterior, inferior and posterior cavernous sinus are 80%,55% and 35% respectively. Conclusion: Particular attention should be given to sphenoid ostia, sella and neurovascular structures in the lateral wall of the sphenoid sinus during endoscopic surgery on sellar area.

关 键 词：鼻腔内窥镜垂体手术 解剖学 蝶窦鞍区病变 

分 类 号：R739.410.5[医药卫生—肿瘤] R322.8[医药卫生—临床医学]